Eyhance or Tecnis Monofocal?
Posted , 10 users are following.
I am a 67 year old woman and I am trying to decide between Eyhance or Tecnis monofocal. My last eye glass prescription was -2.00 for the right eye and -2.25 for the left eye, with -.50 cylinder and 130 axis for the left eye. I tried progressives a few times years ago and could never focus with them, so I went with bifocals instead. When I am reading or using the computer at home I always take my glasses off as I find that more comfortable than trying to look through the bifocal portion of my glasses.
I have been reading the posts on this forum and there have been a lot of positives about Eyhance, but also some negatives. Some of those negatives seem to be surgeon “error” among other things, but some seem to be dissatisfaction with the Eyhance. Also, most Eyhance comments/reviews have been days, weeks maybe a few months after surgery. I have seen very few posts a year or more after getting the Eyhance (I realize this could be because of how new the Eyhance is). I am having a hard time deciding if I should go for the Eyhance or play it safe and go with the tried and true Tecnis monofocal.
I would be getting whichever IOL I get set to distance, so I am realistic and realize I will need to wear readers for computer and reading. I also know myself well enough to know getting monovision is just not an option for me. I am also aware there will be a trade-off with whatever I pick.
My worry about the Eyhance is I wonder if it will be the same as progressive glasses and I will end up never being able to focus with them because of their change in power from the outside to the middle. I also wonder how your pupil size will affect your far or intermediate distance with Eyhance. Will my ability to focus on something be constantly changing because your pupil size is changing because of the lighting? I am outside a lot and realize it will be different on a cloudy day compared to a sunny day, but what about those days where it is sunny, but with a lot of clouds passing over the sun.
I have read numerous studies comparing the Eyhance to other IOLs, but there have been no studies that I can find where they go back a year later and retest/re-question the participants about their satisfaction. After getting over how great it is too see clearly again after getting the cataract removed, does that satisfaction continue or after a number of months are they dissatisfied with it. All the studies seem to agree Eyhance gives you a bit better intermediate vision. One study said it was pupil dependent, but did not expand on that.
I have looked at the defocus curves and I appreciate Eyhance does not give you a “huge” intermediate/near advantage over the monofocal, but when you are talking inches in the intermediate/near range those inches can mean the difference between being able to read your cell phone, see your watch, see the person sitting beside you clearly etc. without putting on reading glasses. My husband has monofocals in both eyes and I watch him put on and take off his readers numerous times a day and he can’t go anywhere without them. I am hoping for a bit better glass independence, but not at the cost of picking an IOL that has problems.
I appreciate all eyes and situations are different and my outcome will not be the same as yours, but I would appreciate any knowledge/experience people have about the Eyhance. This is a life changing decision and more knowledge and information can only help us to make the best decision for us.
Thanks.
0 likes, 91 replies
soks karin08666
Posted
my pre-cataract prescription is similar to yours. do you need glasses for reading or do you do well just taking off the glasses for near vision?
if i started this process all over again i would go with one of the following two scenarios:
eyhance set for -0.5. depending on how much near i get with that i would play with + power contacts in the operated eye a month after the surgery. depending on what i feel comfortable reading at 16-18 inches, i would set the other eyhance as -1 oe -1.25.
i would get clareon panoptix in one eye and BnL sofport monofocal set for -0.5 in the other eye.
good luck.
karin08666 soks
Posted
I take my glasses off to read. I keep going between Eyhance or the Tecnis monofocal. Going to see the surgeon again in a couple days and hopefully he can give me more information on which one would be best for my lifestyle.
Spring1951 karin08666
Posted
That sounds difficult to have use of one eye only but I guess one can adjust over time!
Spoo karin08666
Edited
So I got the Tecnis1 set to emmetropy, we had eyhance lenses ready to go but the calculations would've given me compromised distance vision AND no useful near vision so ultimately I decided to pass on that lens. We also couldn't get a suitable calculation that would've landed me to -.25 on this eye, the next option would've gone to -.5 which would've also compromised my distance.
My vision on my right eye is very blurry currently, but my left eye works great at all distances so i'll survive fine on it without feeling dizzy. If we would've been able to get the eyhance to a better place then it could've still been an option but I might choose it for my left eye, or try something else when the time comes.
karin08666 Spoo
Edited
Very well thought out decision. It is always great when the surgeon walks you through the options and how it will affect your visual outcome. Not all surgeons are like that. I'm glad it went well for you.
RebDovid Spoo
Edited
Congratulations on your (so far) satisfying result.
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Can you, please, explain why the Tecnis 1 and Eyhance calculations differ? Your post makes me think I should ask my surgeon to compare how he'd target the two IOLs.
RonAKA Spoo
Edited
Yes, there is always a decision to make between two steps in the power. Most will select the first negative residual value for a distance set lens. I am surprised that the Eyhance and Tecnis 1 would have calculated differently. From the spec sheets they both have the same optical A Constant of 119.3. Some formulas however can allow the surgeon to input their personal surgeon factor, so perhaps that is what it is about.
Spoo RebDovid
Edited
The calculations are I believe, i forgot to ask copies of them, but I think one of the main issues is that they don't have eyhance in stock, so they couldn't get the 20.00D version which is needed for emmetropia. And the 20.50 lens they had ordered for me would've landed me closer to -0.3 with a chance of slipping further down compromising my distance vision AND not still giving me usable computer vision. Same applied for the 20.50 tecnis1 piece. I told her the worse outcome would be to get an IOL and not have any glasses-free range for any activity so we opted to correct to emmetropia with a tecnis1. So far my vision from the tecnis1 eye looks pretty great and it's not as blurry as I thought it would be. But the surgery was just a few hours ago so i suppose i'll know better once everything settles. Currently even intermediate looks pretty decent with the pure monofocal, but obviously not comfortable. Also maybe my eyeball is still trying to accomodate this plastic thing a bit. I suppose i can expect this to change when healing finishes.
Spoo RonAKA
Posted
I think the main issue was that they didn't have a 20.00 eyhance available for me as it's an order-product. But i can figure out what to do with my second eye regardless when the time comes. Otherwise it would've been an easier choice to make.
Spoo
Edited
Also, I think the calculations not playing to my favor with the eyhance made the choice easier for me to make. I got a great lens with no compromises or weird hacks... obviously except of my intermediate acuity likely. Currently it's not bad, better than expected. But I think i've learned that the first few weeks cannot be trusted.
RebDovid Spoo
Edited
That makes sense. Thank you.
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Your response also ties in with the question I'm trying to ask in my new thread, What's "Good Enough" Visual Accuity. Specifically, talking about compromising distance vision, what do you regard as good enough uncorrected distance visual acuity? Second, what did your surgeon, or your own research, tell you to expect with Tecnis 1 at plano vs. Eyhance at -0.30 or -0.50 D?
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For me, I think 20/22 at distance would be more than "good enough", and although there are no guarantees that's the mean average result at -0.50 D of the three binocular Eyhance defocus curves I've found on-line. Indeed, my wife is happy with 20/25 at distance.
Spring1951 Spoo
Posted
Are you considering intermediate as 20 to 40 inches?
Spoo Spring1951
Posted
anything from ~70-90cm i'd say. The eye definitely is less capable at intermediate now than it was during first day, but that's expected. Currently I can't really get a good focus to anything without glasses for some reason. With +1 readers i have the high-definition vision back without noticeable ghosting and I can read my screen at 70cm without issues, but it's more comfortable with stronger eyewear from my current distance. The monitor is at about 70cm from my face right now (it's a 49" super ultrawide). ~2 days post-op probably doesn't mean much, but I hope my non-glasses vision clears up. I wonder if i'm somehow hyperopic currently. Shooting plano has risks, but the iolmaster didn't give a -0.25 reading for the tecnis1 piece for me. It was plano or -0.49 etc. @RonAKA does the iolmaster take into consideration post-op changes in any way?
Spring1951 Spoo
Posted
I will follow up with you and read the posts as I really want to know what happens. 3 weeks might be the best indicator and then the final 6 weeks to really know for sure.
I don't use intermediate all that much if it is 27 inches to 35 inches. One study showed that Clareon and Eyhance were the same for distance and near vision but Eyhance did better with intermediate so I won't feel bad that I didn't get Eyhance if my near vision is not great.
My doctor targeted 0-.39 D for my LE distance and I hope that will be ok. For Eyhance it had been 0-.25D and she changed it for Clareon.
I will be interested to see how this plays out for you. Good luck!